Fall Workshop 2019 Registration Form
Event Timing: October 19, 2019
Event Address: Orangewood Presbyterian Church, 7321 N 10th St, Phoenix, AZ 85020
Contact us at arizonasuzuki@gmail.com or 520-461-4535

Early Registration Deadline October 1, 2019
Registration Deadline: October 8
To apply: Fill out this registration form (one form per family) and pay fees. Full payment of all fees must accompany your application in order for it to be processed. The registration fee is non-refundable. You can pay by PayPal or mail a check. Please make checks payable to Arizona Suzuki Association and mail to Laura Tagawa, 4745 E. Waverly St., Tucson, AZ 85712. A $35 service fee will be charged for all returned checks. ASA reserves the right to cancel due to insufficient enrollment.
Parent Name *
Your answer
Parent Email *
Your answer
Parent Phone Number *
Your answer
Child #1 Name *
Your answer
Child #1 Instrument *
Your answer
Child #1 Age *
Your answer
Child #1 Current Song Name *
Your answer
Child # 1 Current Suzuki Book Number *
Your answer
Child #1 Teacher's Name *
Your answer
Child #1 Teacher's Email Address *
Your answer
Child #1 Lunch choice (pizza lunch) *
Child #2 Name
Your answer
Child #2 Instrument
Your answer
Child #2 Age
Your answer
Child #2 Current Song Name
Your answer
Child #2 Current Suzuki Book Number
Your answer
Child #2 Teacher's Name
Your answer
Child #2 Teacher's Email Address
Your answer
Child #2 Lunch choice
Child #3 Name
Your answer
Child #3 Instrument
Your answer
Child #3 Age
Your answer
Child #3 Current Song Name
Your answer
Child #3 Current Suzuki Book Number
Your answer
Child #3 Teacher's Name
Your answer
Child #3 Teacher's Email
Your answer
Child #3 Lunch choice
Do you have any siblings who will register for the SECE class? *
If you answered yes to preceding question, please provide answer the following, tell us their name(s) and age(s):
Your answer
Do you plan to buy any extra lunches (for parents, siblings, etc), if so how many and what type? *
Required
I understand that I will have to pay the non-refundable registration fee before Oct 8, 2019. I will pay by *
Required
Comments
Your answer
To complete your registration form, submit this form. Then click the PayPal link at the ASA website. Or mail check payment.
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